Tildrakizumab is recommended as an option for treating plaque psoriasis in adults

Decision Detail

Three restrictions apply:
1. The disease is severe, as defined by a total Psoriasis Area and Severity Index (PASI) of 10 or more and a Dermatology Life Quality Index (DLQI) of more than 10 and
2. The disease has not responded to other systemic treatments, including ciclosporin, methotrexate and phototherapy, or these options are contraindicated or not tolerated and
3. The company provides the drug according to the commercial arrangement.

Summary

The main evidence for tildrakizumab came from the reSURFACE trials (reSURFACE 1 and reSURFACE 2) - double-blind randomised controlled trials that included a total of 1,862 patients with plaque psoriasis. The results showed that tildrakizumab improves severe plaque psoriasis compared with placebo or etanercept. When compared indirectly, tildrakizumab was as effective as adalimumab and ustekinumab but not as effective as other biological treatments. Tildrakizumab is therefore recommended as an alternative to other systemic biological treatments, for patients that have not responded, or if these are contraindicated or not tolerated. The most plausible cost-effectiveness estimates for tildrakizumab compared with most other available biological treatments show that it is a cost-effective use of NHS resources within the stipulated treatment time frames in the guidelines.